Abstract
Arboviruses are transmitted to humans by the bites of infected arthropods, such as mosquitoes and ticks. While most arboviral infections are asymptomatic or result in a non-specific febrile illness, a small proportion cause neuroinvasive disease, presenting most often as meningitis, encephalitis, or myelitis. Some viruses also can cause immune-mediated neurologic complications, such as Guillain-Barré syndrome. Certain viruses and patient characteristics, particularly age and immunosuppression, can lead to greater risk of neuroinvasive disease. The major domestic neurotropic arboviruses are classified in the families Flaviviridae, Peribunyaviridae, and Togaviridae. There are no proven treatments for or licensed vaccines to prevent infections with the domestic arboviruses, and treatment is supportive. Human vaccines are available for a limited number of international neurotropic arboviruses. Prevention of arboviral infection primarily involves using personal protective measures to avoid exposure to the arthropod vectors.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Bres P. Impact of arboviruses on human and animal health. In: Monath TP, editor. The Arboviruses: epidemiology and ecology. Boca Raton, FL: CRC Press; 1988. p. 1–18.
Petersen LR, Brault AC, Nasci RS. West Nile virus: review of the literature. JAMA. 2013;310(3):308–15.
Pealer LN, Marfin AA, Petersen LR, Lanciotti RS, Page PL, Stramer SL, et al. Transmission of West Nile virus through blood transfusion in the United States in 2002. N Engl J Med. 2003;349(13):1236–45.
Winston DJ, Vikram HR, Rabe IB, Dhillon G, Mulligan D, Hong JC, et al. Donor-derived West Nile virus infection in solid organ transplant recipients: report of four additional cases and review of clinical, diagnostic, and therapeutic features. Transplantation. 2014;97(9):881–9.
Centers for Disease Control and Prevention. Possible West Nile virus transmission to an infant through breast-feeding--Michigan, 2002. MMWR Morb Mortal Wkly Rep. 2002;51(39):877–8.
Centers for Disease Control and Prevention. Intrauterine West Nile virus infection--New York, 2002. MMWR Morb Mortal Wkly Rep. 2002;51(50):1135–6.
Hanson RP, Sulkin SE, Beuscher EL, Hammon WM, McKinney RW, Work TH. Arbovirus infections of laboratory workers. Extent of problem emphasizes the need for more effective measures to reduce hazards. Science. 1967;158(3806):1283–6.
Nash D, Mostashari F, Fine A, Miller J, O’Leary D, Murray K, et al. The outbreak of West Nile virus infection in the new York City area in 1999. N Engl J Med. 2001;344(24):1807–14.
Curren EJ, Lehman J, Kolsin J, Walker WL, Martin SW, Staples JE, et al. West Nile virus and other nationally notifiable arboviral diseases - United States, 2017. MMWR Morb Mortal Wkly Rep. 2018;67(41):1137–42.
Centers for Disease Control and Prevention. West Nile virus final cumulative maps & data for 1999–2017. Available from: https://www.cdc.gov/westnile/statsmaps/cumMapsData.html.
Zou S, Foster GA, Dodd RY, Petersen LR, Stramer SL. West Nile fever characteristics among viremic persons identified through blood donor screening. J Infect Dis. 2010;202(9):1354–61.
Mostashari F, Bunning ML, Kitsutani PT, Singer DA, Nash D, Cooper MJ, et al. Epidemic West Nile encephalitis, New York, 1999: results of a household-based seroepidemiological survey. Lancet. 2001;358(9278):261–4.
Lindsey NP, Staples JE, Lehman JA, Fischer M. Medical risk factors for severe West Nile virus disease, United States, 2008-2010. Am J Trop Med Hyg. 2012;87(1):179–84.
Kleinschmidt-DeMasters BK, Marder BA, Levi ME, Laird SP, McNutt JT, Escott EJ, et al. Naturally acquired West Nile virus encephalomyelitis in transplant recipients: clinical, laboratory, diagnostic, and neuropathological features. Arch Neurol. 2004;61(8):1210–20.
Sejvar JJ, Marfin AA. Manifestations of West Nile neuroinvasive disease. Rev Med Virol. 2006;16(4):209–24.
Sejvar JJ. The long-term outcomes of human West Nile virus infection. Clin Infect Dis. 2007;44(12):1617–24.
Anninger WV, Lomeo MD, Dingle J, Epstein AD, Lubow M. West Nile virus-associated optic neuritis and chorioretinitis. Am J Ophthalmol. 2003;136(6):1183–5.
Vaispapir V, Blum A, Soboh S, Ashkenazi H. West Nile virus meningoencephalitis with optic neuritis. Arch Intern Med. 2002;162(5):606–7.
Tsai TF, Mitchell CJ. St. Louis encephalitis. In: Monath TP, editor. The Arboviruses: epidemiology and ecology. Boca Raton: CRC Press; 1988. p. 113–44.
Venkat H, Adams L, Sunenshine R, Krow-Lucal E, Levy C, Kafenbaum T, et al. St. Louis encephalitis virus possibly transmitted through blood transfusion-Arizona, 2015. Transfusion. 2017;57(12):2987–94.
Calisher CH. Medically important arboviruses of the United States and Canada. Clin Microbiol Rev. 1994;7(1):89–116.
Centers for Disease Control and Prevention. St. Louis encephalitis statistics & maps 2019. Available from: https://www.cdc.gov/sle/technical/epi.html.
White MG, Carter NW, Rector FC, Seldin DW, Drewry SJ, Sanford JP, et al. Pathophysiology of epidemic St. Louis encephalitis. I. Inappropriate secretion of antidiuretic hormone. II. Pituitary-adrenal function. III. Cerebral blood flow and metabolism. Ann Intern Med. 1969;71(4):691–702.
Reimann CA, Hayes EB, DiGuiseppi C, Hoffman R, Lehman JA, Lindsey NP, et al. Epidemiology of neuroinvasive arboviral disease in the United States, 1999-2007. Am J Trop Med Hyg. 2008;79(6):974–9.
Ebel GD. Update on Powassan virus: emergence of a north American tick-borne flavivirus. Annu Rev Entomol. 2010;55:95–110.
Stevens T, Taylor L, Annambhotla PD, Destrampe E, Gould CV, Groves J, et al. Probable transfusion-associated transmission of Powassan virus, 2018. CSTE Annual Conference; June 5, 2019; Raleigh, NC.
Krow-Lucal ER, Lindsey NP, Fischer M, Hills SL. Powassan virus disease in the United States, 2006-2016. Vector Borne Zoonotic Dis. 2018;18(6):286–90.
Centers for Disease Control and Prevention. Powassan virus statistics & maps. Available from: https://www.cdc.gov/powassan/statistics.html.
Centers for Disease C, Prevention. Outbreak of Powassan encephalitis--Maine and Vermont, 1999-2001. MMWR Morb Mortal Wkly Rep. 2001;50(35):761–4.
El Khoury MY, Camargo JF, White JL, Backenson BP, Dupuis AP 2nd, Escuyer KL, et al. Potential role of deer tick virus in Powassan encephalitis cases in Lyme disease-endemic areas of New York, U.S. Emerg Infect Dis. 2013;19(12):1926–33.
Piantadosi A, Rubin DB, McQuillen DP, Hsu L, Lederer PA, Ashbaugh CD, et al. Emerging cases of Powassan virus encephalitis in New England: clinical presentation, imaging, and review of the literature. Clin Infect Dis. 2016;62(6):707–13.
Smith R, Woodall JP, Whitney E, Deibel R, Gross MA, Smith V, et al. Powassan virus infection. A report of three human cases of encephalitis. Am J Dis Child. 1974;127(5):691–3.
Birge J, Sonnesyn S. Powassan virus encephalitis, Minnesota. USA Emerg Infect Dis. 2012;18(10):1669–71.
Zachary KC, LaRocque RC, Gonzalez RG, Branda JA. Case 3-2019: a 70-year-old woman with fever, headache, and progressive encephalopathy. N Engl J Med. 2019;380(4):380–7.
Choi EE, Taylor RA. A case of Powassan viral hemorrhagic encephalitis involving bilateral thalami. Clin Neurol Neurosurg. 2012;114(2):172–5.
Raval M, Singhal M, Guerrero D, Alonto A. Powassan virus infection: case series and literature review from a single institution. BMC Res Notes. 2012;5:594.
Gaensbauer JT, Lindsey NP, Messacar K, Staples JE, Fischer M. Neuroinvasive arboviral disease in the United States: 2003 to 2012. Pediatrics. 2014;134(3):e642–50.
Centers for Disease Control and Prevention. La Crosse encephalitis epidemiology & geographic distribution. Available from: https://www.cdc.gov/lac/tech/epi.html.
Hennessey MJ, Pastula DM, Machesky K, Fischer M, Lindsey NP, DiOrio M, et al. Investigation of acute flaccid paralysis reported with La Crosse virus infection, Ohio, USA, 2008-2014. Emerg Infect Dis. 2017;23(12):2075–7.
McJunkin JE, de los Reyes EC, Irazuzta JE, Caceres MJ, Khan RR, Minnich LL, et al. La Crosse encephalitis in children. N Engl J Med. 2001;344(11):801–7.
Andreadis TG, Anderson JF, Armstrong PM, Main AJ. Isolations of Jamestown canyon virus (Bunyaviridae: Orthobunyavirus) from field-collected mosquitoes (Diptera: Culicidae) in Connecticut, USA: a ten-year analysis, 1997-2006. Vector Borne Zoonotic Dis. 2008;8(2):175–88.
Kosoy O, Rabe I, Geissler A, Adjemian J, Panella A, Laven J, et al. Serological survey for antibodies to mosquito-borne bunyaviruses among US National Park Service and US Forest Service employees. Vector Borne Zoonotic Dis. 2016;16(3):191–8.
Pastula DM, Hoang Johnson DK, White JL, Dupuis AP 2nd, Fischer M, Staples JE. Jamestown Canyon virus disease in the United States-2000-2013. Am J Trop Med Hyg. 2015;93(2):384–9.
Grimstad PR, Shabino CL, Calisher CH, Waldman RJ. A case of encephalitis in a human associated with a serologic rise to Jamestown canyon virus. Am J Trop Med Hyg. 1982;31(6):1238–44.
Deibel R, Srihongse S, Grayson MA, Grimstad PR, Mahdy MS, Artsob H, et al. Jamestown canyon virus: the etiologic agent of an emerging human disease? Prog Clin Biol Res. 1983;123:313–25.
Grimstad PR. California group virus disease. In: Monath TP, editor. The arboviruses: epidemiology and ecology. Boca Raton: CRC Press; 1988. p. 99–136.
Centers for Disease Control and Prevention. Human Jamestown canyon virus infection --- Montana, 2009. MMWR Morb Mortal Wkly Rep. 2011;60(20):652–5.
Calisher CH, Francy DB, Smith GC, Muth DJ, Lazuick JS, Karabatsos N, et al. Distribution of Bunyamwera serogroup viruses in North America, 1956-1984. Am J Trop Med Hyg. 1986;35(2):429–43.
Campbell GL, Mataczynski JD, Reisdorf ES, Powell JW, Martin DA, Lambert AJ, et al. Second human case of Cache Valley virus disease. Emerg Infect Dis. 2006;12(5):854–6.
Nguyen NL, Zhao G, Hull R, Shelly MA, Wong SJ, Wu G, et al. Cache valley virus in a patient diagnosed with aseptic meningitis. J Clin Microbiol. 2013;51(6):1966–9.
Sexton DJ, Rollin PE, Breitschwerdt EB, Corey GR, Myers SA, Dumais MR, et al. Life-threatening Cache Valley virus infection. N Engl J Med. 1997;336(8):547–9.
Wilson MR, Suan D, Duggins A, Schubert RD, Khan LM, Sample HA, et al. A novel cause of chronic viral meningoencephalitis: Cache Valley virus. Ann Neurol. 2017;82(1):105–14.
Yang Y, Qiu J, Snyder-Keller A, Wu Y, Sun S, Sui H, et al. Fatal Cache Valley virus meningoencephalitis associated with rituximab maintenance therapy. Am J Hematol. 2018;93(4):590–4.
Morris CD. Eastern equine encephalomyelitis. In: Monath TP, editor. The arboviruses: epidemiology and ecology. Boca Raton: CRC Press; 1988. p. 1–20.
Bingham AM, Burkett-Cadena ND, Hassan HK, McClure CJ, Unnasch TR. Field investigations of winter transmission of eastern equine encephalitis virus in Florida. Am J Trop Med Hyg. 2014;91(4):685–93.
Roy CJ, Reed DS, Wilhelmsen CL, Hartings J, Norris S, Steele KE. Pathogenesis of aerosolized eastern equine encephalitis virus infection in guinea pigs. Virol J. 2009;6:170.
Pouch SM, Katugaha SB, Shieh WJ, Annambhotla P, Walker WL, Basavaraju SV, et al. Transmission of eastern equine encephalitis virus from an organ donor to three transplant recipients. Clin Infect Dis 2019;69(3);450–8.
Getting VA. Equine encephalomyelitis in Massachusetts. N Engl J Med. 1941;224(24):999–1006.
Goldfield M, Sussman O. The 1959 outbreak of eastern encephalitis in New Jersey. I. Introduction and description of outbreak. Am J Epidemiol. 1968;87(1):1–10.
Carrera JP, Forrester N, Wang E, Vittor AY, Haddow AD, Lopez-Verges S, et al. Eastern equine encephalitis in Latin America. N Engl J Med. 2013;369(8):732–44.
Centers for Disease Control and Prevention. Eastern equine encephalitis statistics & maps. Available from: https://www.cdc.gov/easternequineencephalitis/tech/epi.html.
Bigler WJ, Lassing EB, Buff EE, Prather EC, Beck EC, Hoff GL. Endemic eastern equine encephalomyelitis in Florida: a twenty-year analysis, 1955-1974. Am J Trop Med Hyg. 1976;25(6):884–90.
Sherwood JA, Oliver J. Eastern equine encephalitis incubation time periods of 5 and 8 days. Pediatr Infect Dis J. 2015;34(4):459–60.
Goldfield M, Welsh JN, Taylor BF. The 1959 outbreak of eastern encephalitis in New Jersey. 5. The inapparent infection:disease ratio. Am J Epidemiol. 1968;87(1):32–3.
Deresiewicz RL, Thaler SJ, Hsu L, Zamani AA. Clinical and neuroradiographic manifestations of eastern equine encephalitis. N Engl J Med. 1997;336(26):1867–74.
Ayres JC, Feemster RF. The sequelae of eastern equine encephalomyelitis. N Engl J Med. 1949;240(24):960–2.
Ronca SE, Dineley KT, Paessler S. Neurological sequelae resulting from encephalitic alphavirus infection. Front Microbiol. 2016;7:959.
Weaver SC, Kang W, Shirako Y, Rumenapf T, Strauss EG, Strauss JH. Recombinational history and molecular evolution of western equine encephalomyelitis complex alphaviruses. J Virol. 1997;71(1):613–23.
Reisen WK, Monath TP. Western equine encephalomyelitis. In: Monath TP, editor. The arboviruses: epidemiology and ecology. Boca Raton: CRC Press; 1988. p. 89–137.
Forrester NL, Kenney JL, Deardorff E, Wang E, Weaver SC. Western equine encephalitis submergence: lack of evidence for a decline in virus virulence. Virology. 2008;380(2):170–2.
Mossel EC, Ledermann JP, Phillips AT, Borland EM, Powers AM, Olson KE. Molecular determinants of mouse neurovirulence and mosquito infection for Western equine encephalitis virus. PLoS One. 2013;8(3):e60427.
Kokernot RH, Shinefield HR, Longshore WA Jr. The 1952 outbreak of encephalitis in California; differential diagnosis. Calif Med. 1953;79(2):73–7.
Medovy H. Western equine encephalomyelitis in infants. J Pediatr. 1943;22(3):308–18.
McGowan JE Jr, Bryan JA, Gregg MB. Surveillance of arboviral encephalitis in the United States, 1955-1971. Am J Epidemiol. 1973;97(3):199–207.
Schultz DR, Barthal JS, Garrett G. Western equine encephalitis with rapid onset of parkinsonism. Neurology. 1977;27(11):1095–6.
Centers for Disease Control and Prevention. CDC yellow book 2020: health information for international travel. Brunett GW, editor. New York: Oxford University Press; 2019.
Gubler DJ. The global emergence/resurgence of arboviral diseases as public health problems. Arch Med Res. 2002;33(4):330–42.
Carod-Artal FJ, Wichmann O, Farrar J, Gascon J. Neurological complications of dengue virus infection. Lancet Neurol. 2013;12(9):906–19.
Solomon T, Dung NM, Vaughn DW, Kneen R, Thao LT, Raengsakulrach B, et al. Neurological manifestations of dengue infection. Lancet. 2000;355(9209):1053–9.
Hills SL, Walter EB, Atmar RL, Fischer M. Japanese encephalitis vaccine: recommendations of the advisory committee on immunization practices (ACIP). MMWR Morb Mortal Wkly Rep. 2019;68(2):1–33.
Lipowski D, Popiel M, Perlejewski K, Nakamura S, Bukowska-Osko I, Rzadkiewicz E, et al. A cluster of fatal tick-borne encephalitis virus infection in organ transplant setting. J Infect Dis. 2017;215(6):896–901.
Wahlberg P, Saikku P, Brummer-Korvenkontio M. Tick-borne viral encephalitis in Finland. The clinical features of Kumlinge disease during 1959-1987. J Intern Med. 1989;225(3):173–7.
Fischer M, Gould CV, Rollin PE. Tickborne encephalitis. In: Brunett GW, editor. CDC yellow book 2020: health information for international travel. New York: Oxford University Press; 2019.
Centers for Disease Control and Prevention. Tick-borne encephalitis among U.S. travelers to Europe and Asia - 2000-2009. MMWR Morb Mortal Wkly Rep. 2010;59(11):335–8.
Gaibani P, Rossini G. An overview of Usutu virus. Microbes Infect. 2017;19(7–8):382–7.
Roesch F, Fajardo A, Moratorio G, Vignuzzi M. Usutu virus: an arbovirus on the rise. Viruses. 2019;11:640–53.
Grottola A, Marcacci M, Taqliazucchi S, Gennari W, Di Gennaro A, Orsini M, et al. Usutu virus infections in humans: a retrospective analysis in the municipality of Modena. Italy Clin Microbiol Infect. 2017;23(1):33–7.
Munoz LS, Parra B, Pardo CA, Neuroviruses Emerging in the Americas Study. Neurological implications of Zika virus infection in adults. J Infect Dis. 2017;216(suppl_10):S897–905.
da Silva IRF, Frontera JA. Bispo de Filippis AM, Nascimento OJMD, Rio-GBS-ZIKV research group. Neurologic complications associated with the Zika virus in Brazilian adults. JAMA Neurol. 2017;74(10):1190–8.
Depaquit J, Grandadam M, Fouque F, Andry P, Peyrefitte C. Arthropod-borne viruses transmitted by Phlebotomine sandflies in Europe: a review. Euro Surveill. 2010;15(10):pii=19507.
Kay MK, Gibney KB, Riedo FX, Kosoy OL, Lanciotti RS, Lambert AJ. Toscana virus infection in American traveler returning from Sicily, 2009. Emerg Infect Dis. 2010;16(9):1498–500.
Hoyer IJ, Acevedo C, Wiggins K, Alto BW, Burkett-Cadena ND. Patterns of abundance, host use, and Everglades virus infection in Culex (Melanoconion) cedecei mosquitoes, Florida, USA. Emerg Infect Dis. 2019;25(6):1093–100.
Weaver SC, Ferro C, Barrera R, Boshell J, Navarro JC. Venezuelan equine encephalitis. Annu Rev Entomol. 2004;49:141–74.
Go YY, Balasuriya UB, Lee CK. Zoonotic encephalitides caused by arboviruses: transmission and epidemiology of alphaviruses and flaviviruses. Clin Exp Vaccine Res. 2014;3(1):58–77.
Aguilar PV, Estrada-Franco JG, Navarro-Lopez R, Ferro C, Haddow AD, Weaver SC. Endemic Venezuelan equine encephalitis in the Americas: hidden under the dengue umbrella. Future Virol. 2011;6(6):721–40.
Griffin I, Martin SW, Fischer M, Chambers TV, Kosoy O, Falise A, et al. Zika virus IgM detection and neutralizing antibody profiles 12-19 months after illness onset. Emerg Infect Dis. 2019;25(2):299–303.
Kapoor H, Signs K, Somsel P, Downes FP, Clark PA, Massey JP. Persistence of West Nile virus (WNV) IgM antibodies in cerebrospinal fluid from patients with CNS disease. J Clin Virol. 2004;31(4):289–91.
Roehrig JT, Nash D, Maldin B, Labowitz A, Martin DA, Lanciotti RS, et al. Persistence of virus-reactive serum immunoglobulin M antibody in confirmed West Nile virus encephalitis cases. Emerg Infect Dis. 2003;9(3):376–9.
Levi ME, Quan D, Ho JT, Kleinschmidt-Demasters BK, Tyler KL, Grazia TJ. Impact of rituximab-associated B-cell defects on West Nile virus meningoencephalitis in solid organ transplant recipients. Clin Transpl. 2010;24(2):223–8.
Calisher CH, Karabatsos N, Dalrymple JM, Shope RE, Porterfield JS, Westaway EG, et al. Antigenic relationships between flaviviruses as determined by cross-neutralization tests with polyclonal antisera. J Gen Virol. 1989;70(Pt 1):37–43.
Centers for Disease Control and Prevention. West Nile virus disease therapeutics: review of the literature for healthcare providers. Available from: https://www.cdc.gov/westnile/healthcareproviders/healthCareProviders-TreatmentPrevention.html.
National Institutes of Health. U.S. National Library of Medicine Clinical Trials.gov. Available from: https://clinicaltrials.gov/ct2/results?term=west+nile+virus&Search=Search.
Centers for Disease Control and Prevention. Prevent mosquito bites. Available from: https://www.cdc.gov/features/stopmosquitoes/index.html.
Centers for Disease Control and Prevention. Avoiding ticks. Available from: https://www.cdc.gov/ticks/avoid/index.html.
Brandler S, Tangy F. Vaccines in development against West Nile virus. Viruses. 2013;5(10):2384–409.
U.S. Food & Drug Administration. Use of nucleic acid tests to reduce the risk of transmission of West Nile virus from donors of whole blood and blood components intended for transfusion. Available from: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/use-nucleic-acid-tests-reduce-risk-transmission-west-nile-virus-donors-whole-blood-and-blood.
Busch MP, Kleinman SH, Tobler LH, Kamel HT, Norris PJ, Walsh I, et al. Virus and antibody dynamics in acute West Nile virus infection. J Infect Dis. 2008;198(7):984–93.
U.S. Food & Drug Administration. Revised recommendations for reducing the risk of Zika virus transmission by blood and blood components. Available from: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/revised-recommendations-reducing-risk-zika-virus-transmission-blood-and-blood-components.
Barjas-Castro ML, Angerami RN, Cunha MS, Suzuki A, Nogueira JS, Rocco IM, et al. Probable transfusion-transmitted Zika virus in Brazil. Transfusion. 2016;56(7):1684–8.
Motta IJ, Spencer BR. Cordeiro da Silva SG, Arruda MB, dobbin JA, Gonzaga YB, et al. evidence for transmission of Zika virus by platelet transfusion. N Engl J Med. 2016;375(11):1101–3.
Cheng VCC, Sridhar S, Wong SC, Wong SCY, Chan JFW, Yip CCY, et al. Japanese encephalitis virus transmitted via blood transfusion, Hong Kong, China. Emerg Infect Dis. 2018;24(1):49.
Basavaraju SV, Kuehnert MJ, Zaki SR, Sejvar JJ. Encephalitis caused by pathogens transmitted through organ transplants, United States, 2002-2013. Emerg Infect Dis. 2014;20(9):1443–51.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Gould, C., Fischer, M. (2021). Arboviral Central Nervous System Infections. In: Hasbun, MD MPH, R., Bloch, MD MPH, K.C., Bhimraj, MD, A. (eds) Neurological Complications of Infectious Diseases. Current Clinical Neurology. Humana, Cham. https://doi.org/10.1007/978-3-030-56084-3_7
Download citation
DOI: https://doi.org/10.1007/978-3-030-56084-3_7
Published:
Publisher Name: Humana, Cham
Print ISBN: 978-3-030-56083-6
Online ISBN: 978-3-030-56084-3
eBook Packages: MedicineMedicine (R0)